Earlier this week, members of the House Energy and Commerce Committee released legislation as part of the House Republicans’ efforts to repeal and replace Obamacare. Although the legislation cleared its first hurdle with a lengthy, contentious markup session that began Wednesday, the House Ways and Means Committee approved the American Health Care Act. The House Energy and Commerce Committee continued debating the legislation well into Thursday. Many health care organizations are speaking out against the legislation.

Prohibit health insurers from denying coverage or charging more to patients based on pre-existing conditions.

Help young adults access health insurance and stabilize the marketplace by allowing dependents to continue staying on their parents’ plan until they are 26.

Establish a Patient and State Stability Fund, which provides states with $100 billion to design programs that meet the unique needs of their patient populations and help low-income Americans afford health care.

Modernize and strengthen Medicaid by transitioning to a “per capita allotment” so states can better serve the patients most in need.

Empower individuals and families to spend their health care dollars the way they want and need by enhancing and expanding Health Savings Accounts (HSAs).

Help Americans access affordable, quality health care by providing a monthly tax credit for low- and middle-income individuals and families who don’t receive insurance through work or a government program.

Although Democrats and Republicans are beginning to speak against the bill, perhaps most critical of the legislation has been the American Medical Association, which issued a letter to congressional leaders stating that it cannot support the bill.

“While we agree that there are problems with the ACA that must be addressed, we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations,” it said.

AMA President Dr. Andrew Gurman introduced the letter on the AMA’s website by stating: “We all know that our health system is highly complex, but our core commitment to the patients most in need should be straightforward. As the AMA has previously stated, members of Congress must keep top of mind the potentially life-altering impact their policy decisions will have.”

Similarly, the American Nurses Association and the American Hospital Association have expressed strong opposition to the proposed American Health Care Act citing fundamental changes in Medicare and Medicaid, which the groups argue could limit access to care while “in no way improving care.”

“It appears that the effort to restructure the Medicaid program will have the effect of making significant reductions in a program that provides services to our most vulnerable populations,” wrote Richard Pollack, CEO and president of the American Hospital Association, in his letter to members of Congress.

The legislation does not yet have a score from the Congressional Budget Office, which could provide an estimate of the bill’s cost and impact on coverage levels. However, White House representatives have indicated a score will soon be released.

Other medical groups are expressing concern about the speed at which the bill appears to be moving.

“We are concerned that by rushing to a mark-up … in the Energy and Commerce and Ways and Means Committees, there will be insufficient time to obtain non-partisan estimates of this legislation’s impact by the Congressional Budget Office, or for medical organizations like ours and other key stakeholders in the health care community to offer substantive input on the bill,” the American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Congress of Obstetricians and Gynecologists: and the American Osteopathic Association said in a joint statement.